Columbia University proposes to continue its NLM-supported training program in medical informatics, initiated in 1992 and expanded in 1997. Our goal is to help to shape the evolving discipline of biomedical informatics by defining a rigorous, academically oriented training program that offers complementary exposures to real-world systems, both in clinical settings here at CPMC and in the biological sciences through the Columbia Genome Center and its nascent Center for Computational Biology and Bioinformatics. Our training program seeks to further the development of the field and the quality of future research by demonstrating to its students and to the biomedical community that medical informatics addresses fundamental issues of biomedical knowledge and information, their representation, and their biomedical application. We have accordingly developed a curriculum that assures that our graduates will be familiar with a broad range of pertinent topics in the field. Each trainee then selects an area of subspecialization within the field, with the established tracks being clinical informatics, public health informatics, imaging informatics, or bioinformatics. Our degrees generally require a minimum of two years for the M.A. and four years for the Ph.D., although most students take somewhat longer. We expect over 50 graduate students and post-doctoral trainees in our program in September 2001. Among our 47 graduates since approval of our degree program, we have graduated 4 PhD students, two of whom were NLM supported. We have had 15 graduates of our research masters program, 11 of whom were NLM supported. Our remaining 28 graduates have earned applied masters degrees, but none has been NLM supported. We have a large, internationally recognized faculty with consistent involvement in national medical informatics projects. Education for our trainees involves one-on-one experience with faculty members, working on research projects that in many cases are conceived by the students themselves. Almost all trainees are formal degree candidates and take coursework from within the Department and from the excellent resources available at Columbia University. The faculty, research staff and students form a critical mass for providing a provocative environment for the seminars, journal clubs, and information discussions. Our clinical information systems service responsibilities offer trainees opportunities to get first-hand exposure to and training on state-of-the-art clinical, educational, administrative, and research information systems.